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Atigossou OLG, Demers MH, Paquet MP, Bradet-Levesque I, Campeau-Lecours A, Routhier F, Flamand VH. Usability of mechanical assistive technologies for performing activities involving the upper extremities in individuals with impairments: a systematic review. Disabil Rehabil Assist Technol 2024:1-20. [PMID: 38864384 DOI: 10.1080/17483107.2024.2356833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 05/13/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE To conduct a systematic review on the impacts of using mechanical assistive devices on function, performance in activities and participation of persons with upper extremity impairments, and to synthesize the strengths and limitations of these devices. METHOD Three independent reviewers conducted systematic searches of articles published between 2003 and 2023 in Compendex, Inspec, Embase, PubMed/Medline, IEEE Xplore, and Web of Science, as well as manual searches on the RESNA website for conference papers over the same period. The methodological quality of articles was appraised using the QualSyst tool. RESULTS From the 34 retained studies, 28 mechanical devices were identified and classified into two categories: (1) mobile arm supports (MASs) designed to perform multiple activities, and (2) devices used to assist with a specific activity of daily living (ADL). Overall, MASs helped users to perform manual activities in elevation and/or against gravity. Specific ADL devices allowed users to perform unique activities requiring fine motor skills such as opening a medicine container. Some of these devices have advantages like portability, adaptability, low cost, and ease of use. Limitations most often reported included interference or mobility restraints. CONCLUSION This review synthesizes the impacts of mechanical devices on the three domains of the International Classification of Functioning, Disability and Health (ICF) for individuals with upper extremity impairments. Impacts regarding function and performance in activities were more often measured than participation. Future studies should include outcomes related to participation, as taking this aspect into account might favor successful continued use of assistive devices.
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Affiliation(s)
- Orthelo Léonel Gbètoho Atigossou
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
| | - Marie-Hélène Demers
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
| | - Marie-Philippe Paquet
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
| | - Isabelle Bradet-Levesque
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
| | - Alexandre Campeau-Lecours
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
| | - François Routhier
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
| | - Véronique H Flamand
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
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2
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Bouffard J, Lettre J, Campeau-Lecours A, Pacciolla D, Lemelin B, Routhier F. Use of a dynamic arm support to drive a power wheelchair: a case report. Disabil Rehabil Assist Technol 2024; 19:506-515. [PMID: 35867651 DOI: 10.1080/17483107.2022.2102258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Dynamic arm supports (DAS) can assist individuals with severe upper limb disabilities who use a wheelchair to accomplish their daily activities. The objective of this case series was to assess the potential of a DAS to improve power wheelchair (PWC) control in real-life contexts and to describe the integration process. A secondary objective was to explore factors that may influence the DAS integration process. METHODS This case series includes four participants fitted with the Kinova DAS O110. A one-year follow-up was planned for each participant with qualitative and quantitative data collection to assess DAS outcomes. Assessment methods were selected to cover the three vantages of assistive technology outcomes assessment: effectiveness, subjective well-being, and social significance. RESULTS Among the four participants, one used the DAS to help with his wheelchair control for at least 12 months (successful integration). For him, the DAS led to significantly improved wheelchair skills and an important positive psychosocial impact. He was, however, only able to use the DAS for PWC control (no effects on other daily activities), and could not use it in some contexts because the device increased his PWC width. As for the other participants, they stopped using the DAS for different reasons, including a DAS-related adverse event. CONCLUSION This study demonstrated that a wheelchair-bound DAS has the potential to improve PWC use, but successful integration requires specific factors. The service delivery process and the environmental accessibility are crucial for the successful integration of such a device and to avoid safety issues.IMPLICATIONS FOR REHABILITATIONNo study deeply assessed the impacts of dynamic arm support on power wheelchair control, and the associated facilitators and obstacles.A wheelchair-bound dynamic arm support has the potential to improve power wheelchair control for individuals with upper limb disabilities and to lead to positive psychosocial impacts if some conditions conductive to successful integration are met.The service delivery process and the environmental accessibility appear as crucial aspects for the successful integration of a new device, such as dynamic arm support and avoiding safety issues.
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Affiliation(s)
- Jason Bouffard
- Department of Kinesiology, Université Laval, Quebec City, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
| | - Josiane Lettre
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
| | - Alexandre Campeau-Lecours
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
- Department of Mechanical Engineering, Université Laval, Quebec City, Canada
| | - David Pacciolla
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montreal, Canada
| | - Bruno Lemelin
- Wheelchair and Posture Unit, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
| | - François Routhier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
- Department of Rehabilitation, Université Laval, Quebec City, Canada
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3
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Lebrasseur A, Lettre J, Routhier F, Bouffard J, Archambault PS, Campeau-Lecours A. Evaluation of the usability of an actively actuated arm support. Assist Technol 2021; 33:271-277. [PMID: 31207199 DOI: 10.1080/10400435.2019.1629124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Dynamic arm supports can be used to increase the autonomy of people with upper limb disabilities, but their usability is often poorly documented. The objective of this study is to evaluate the usability of an actuated arm support (AAS), namely the Gowing power-assisted arm support. Nine participants with neurological disorders restricting their upper limb capacities (DASH = 63.51 ± 7.72) completed various tasks (Upper Extremity Performance Test for the Elderly (TEMPA)) with and without the AAS. Users' satisfaction (Quebec User Evaluation of Satisfaction with assistive Technology (QUEST)) and perceived benefits of the device (semi-structured interviews) were assessed. Large (effect size ≥ 1.15) and statistically significant (p < .05) improvements were found in the TEMPA functional rating, range of motion, strength, precision of gross movements and prehension patterns subscales while using the AAS. Two third of the participants were quite or very satisfied with the arm support (QUEST > 4/5) and interviews were positive about its usefulness in daily living activities. Our study demonstrated that the use of an AAS could result in significant improvements in the autonomy of people with upper limb disabilities.
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Affiliation(s)
- Audrey Lebrasseur
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Institut de réadaptation en déficience physique de Québec, Quebec City, QC, Canada.,Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
| | - Josiane Lettre
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Institut de réadaptation en déficience physique de Québec, Quebec City, QC, Canada
| | - François Routhier
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Institut de réadaptation en déficience physique de Québec, Quebec City, QC, Canada.,Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
| | - Jason Bouffard
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Institut de réadaptation en déficience physique de Québec, Quebec City, QC, Canada.,Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
| | - Philippe S Archambault
- Interdisciplinary Research Center in Rehabilitation, Centre intégré de santé et de services sociaux de Laval, Laval, Canada.,School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada
| | - Alexandre Campeau-Lecours
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Institut de réadaptation en déficience physique de Québec, Quebec City, QC, Canada.,Department of Mechanical Engineering, Université Laval, Quebec City, QC, Canada
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Houwen-van Opstal SLS, van den Elzen YMEM, Jansen M, Willemsen MAAP, Cup EHC, De Groot IJM. Facilitators and Barriers to Wearing Hand Orthoses by Adults with Duchenne Muscular Dystrophy: A Mixed Methods Study Design. J Neuromuscul Dis 2021; 7:467-475. [PMID: 32568104 PMCID: PMC7592678 DOI: 10.3233/jnd-200506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background: To retard shortening of finger flexors in patients with Duchenne muscular dystrophy (DMD), hand orthoses are prescribed. However, many patients do not wear the orthoses regularly. To optimize orthotic interventions, we need insight into the factors influencing compliance. Objective: To evaluate the compliance regarding hand orthoses in an adult DMD population and to explore experiences and perceptions of DMD patients wearing orthoses, and of their caregivers. Methods: Mixed methods observational study, combining quantitative and qualitative data from medical charts combined with qualitative semi-structured interviews using a constant comparative method and a short validated questionnaire (D-QUEST). Results: 65 medical charts were analyzed. 48 patients were assessed as needing hand orthoses, of whom 37.5 % were compliant. Qualitative data analyses revealed (1) motivation: preservation of hand function; (2) barriers: discomfort and impediments; (3) facilitators: good fit and personalized wearing schedule; (4) fitting process: satisfactory, but patients do not readily seek help when barriers appear. Conclusions: Patients are motivated to wear hand orthoses, but often discontinue use because of orthosis-and disease-specific barriers. The identification of these barriers leads to practical and feasible recommendations concerning the orthoses and the fitting process, such as less rigid material, preservation of some function while wearing the orthoses, and fixed evaluation points. The findings were confirmed by the D-QUEST.
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Affiliation(s)
- S L S Houwen-van Opstal
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands.,Amalia Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Y M E M van den Elzen
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M Jansen
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands.,Amalia Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
| | - M A A P Willemsen
- Amalia Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
| | - E H C Cup
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
| | - I J M De Groot
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands.,Amalia Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
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5
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Longatelli V, Antonietti A, Biffi E, Diella E, D'Angelo MG, Rossini M, Molteni F, Bocciolone M, Pedrocchi A, Gandolla M. User-centred assistive SystEm for arm Functions in neUromuscuLar subjects (USEFUL): a randomized controlled study. J Neuroeng Rehabil 2021; 18:4. [PMID: 33407580 PMCID: PMC7789525 DOI: 10.1186/s12984-020-00794-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/01/2020] [Indexed: 12/16/2022] Open
Abstract
Background Upper limb assistive devices can compensate for muscular weakness and empower the user in the execution of daily activities. Multiple devices have been recently proposed but there is still a lack in the scientific comparison of their efficacy. Methods We conducted a cross-over multi-centric randomized controlled trial to assess the functional improvement at the upper limb level of two arms supports on 36 patients with muscular dystrophy. Participants tested a passive device (i.e., Wrex by Jaeco) and a semi-active solution for gravity compensation (i.e., Armon Ayura). We evaluated devices’ effectiveness with an externally-assessed scale (i.e., Performance of the Upper Limb-PUL-module), a self-perceived scale (i.e., Abilhand questionnaire), and a usability scale (i.e., System Usability Scale). Friedman’s test was used to assess significant functional gain for PUL module and Abilhand questionnaire. Moreover, PUL changes were compared by means of the Friedman’s test. Results Most of the patients improved upper limb function with the use of arm supports (median PUL scores increase of 1–3 points). However, the effectiveness of each device was related to the level of residual ability of the end-user. Slightly impaired patients maintained the same independence without and with assistive devices, even if they reported reduced muscular fatigue for both devices. Moderately impaired patients enhanced their arm functionality with both devices, and they obtained higher improvements with the semi-active one (median PUL scores increase of 9 points). Finally, severely impaired subjects benefited only from the semi-active device (median PUL scores increase of 12 points). Inadequate strength was recognized as a barrier to passive devices. The usability, measured by the System Usability Scale, was evaluated by end-users “good” (70/100 points) for the passive, and “excellent” (80/100 points) for the semi-active device. Conclusions This study demonstrated that assistive devices can improve the quality of life of people suffering from muscular dystrophy. The use of passive devices, despite being low cost and easy to use, shows limitations in the efficacy of the assistance to daily tasks, limiting the assistance to a predefined horizontal plane. The addition of one active degree of freedom improves efficacy and usability especially for medium to severe patients. Further investigations are needed to increase the evidence on the effect of arm supports on quality of life and diseases’ progression in subjects with degenerative disorders. Trial registration clinicaltrials.gov, NCT03127241, Registered 25th April 2017. The clinical trial was also registered as a post-market study at the Italian Ministry of Health.
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Affiliation(s)
- Valeria Longatelli
- NeuroEngineering And medical Robotics Laboratory, NearLab, Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Via Giuseppe Colombo 40, 20133, Milan, Italy
| | - Alberto Antonietti
- NeuroEngineering And medical Robotics Laboratory, NearLab, Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Via Giuseppe Colombo 40, 20133, Milan, Italy
| | - Emilia Biffi
- Scientific Institute IRCCS E. Medea, Via Don Luigi Monza 20, 23842, Bosisio Parini, Italy
| | - Eleonora Diella
- Scientific Institute IRCCS E. Medea, Via Don Luigi Monza 20, 23842, Bosisio Parini, Italy
| | - Maria Grazia D'Angelo
- Scientific Institute IRCCS E. Medea, Via Don Luigi Monza 20, 23842, Bosisio Parini, Italy
| | - Mauro Rossini
- Valduce Hospital, Villa Beretta Rehabilitation Center, Via Nazario Sauro 17, 23845, Costa Masnaga, Italy
| | - Franco Molteni
- Valduce Hospital, Villa Beretta Rehabilitation Center, Via Nazario Sauro 17, 23845, Costa Masnaga, Italy
| | - Marco Bocciolone
- Department of Mechanical Engineering, Politecnico di Milano, Via Giuseppe La Masa 1, 20156, Milan, Italy
| | - Alessandra Pedrocchi
- NeuroEngineering And medical Robotics Laboratory, NearLab, Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Via Giuseppe Colombo 40, 20133, Milan, Italy
| | - Marta Gandolla
- NeuroEngineering And medical Robotics Laboratory, NearLab, Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Via Giuseppe Colombo 40, 20133, Milan, Italy. .,Department of Mechanical Engineering, Politecnico di Milano, Via Giuseppe La Masa 1, 20156, Milan, Italy.
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6
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Essers JMN, Murgia A, Peters AA, Janssen MMHP, Meijer K. Recommendations for studies on dynamic arm support devices in people with neuromuscular disorders: a scoping review with expert-based discussion. Disabil Rehabil Assist Technol 2020; 17:487-500. [PMID: 32981390 DOI: 10.1080/17483107.2020.1806937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Neuromuscular disorders are characterised by muscle weakness that limits upper extremity mobility, but can be alleviated with dynamic arm support devices. Current research highlights the importance and difficulties of evidence-based recommendations for device development. We aim to provide research recommendations primarily concerning upper extremity body functions, and secondarily activity and participation, environmental and personal factors. METHODS Evidence was synthesised from literature, ongoing studies, and expert opinions and tabulated within a framework based on a combination of the International Classification of Functioning, Disability and Health (ICF) model and contextual constructs. RESULTS Current literature mostly investigated the motor capacity of muscle function, joint mobility, and upper body functionality, and a few studies also addressed the impact on activity and participation. In addition, experts considered knowledge on device utilisation in the daily environment and characterising the beneficiaries better as important. Knowledge gaps showed that ICF model components and contextual constructs should be better integrated and more actively included in future research. CONCLUSIONS It is recommended to, first, integrate multiple ICF model components and contextual constructs within one study design. Second, include the influence of environmental and personal factors when developing and deploying a device. Third, include short-term and long-term measurements to monitor adaptations over time. Finally, include user satisfaction as guidance to evaluate the device effectiveness.IMPLICATIONS ON REHABILITATIONSynthesized evidence will support future research and development of dynamic arm supports.Tabulated evidence stresses the importance of integrating ICF model components and contextual constructs to fill the knowledge gaps.Presented knowledge gaps and proposed steps guide the set up of future studies on dynamic arm supports.
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Affiliation(s)
- J M N Essers
- Department of Nutrition and Movement Sciences, NUTRIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - A Murgia
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - A A Peters
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M M H P Janssen
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - K Meijer
- Department of Nutrition and Movement Sciences, NUTRIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
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7
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Essers J, Murgia A, Peters A, Meijer K. Daily Life Benefits and Usage Characteristics of Dynamic Arm Supports in Subjects with Neuromuscular Disorders. SENSORS (BASEL, SWITZERLAND) 2020; 20:E4864. [PMID: 32872138 PMCID: PMC7506722 DOI: 10.3390/s20174864] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/24/2020] [Accepted: 08/26/2020] [Indexed: 12/12/2022]
Abstract
Neuromuscular disorders cause progressive muscular weakness, which limits upper extremity mobility and performance during activities of daily life. Dynamic arm supports can improve mobility and quality of life. However, their use is often discontinued over time for unclear reasons. This study aimed to evaluate whether users of dynamic arm supports demonstrate and perceive quantifiable mobility benefits over a period of two months. Nine users of dynamic arm supports were included in this observational study. They had different neuromuscular disorders and collectively used four different arm supports. They were observed for three consecutive weeks during which they were equipped with a multi-sensor network of accelerometers to assess the actual use of the arm support and they were asked to provide self-reports on the perceived benefits of the devices. Benefits were experienced mainly during anti-gravity activities and the measured use did not change over time. The self-reports provided contextual information in domains such as participation to social life, in addition to the sensor system. However self-reports overestimated the actual use by up to three-fold compared to the accelerometer measures. A combination of objective and subjective methods is recommended for meaningful and quantifiable mobility benefits during activities of daily life.
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Affiliation(s)
- Johannes Essers
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229ER Maastricht, The Netherlands;
| | - Alessio Murgia
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, 9713AV Groningen, The Netherlands;
| | - Anneliek Peters
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, 9713AV Groningen, The Netherlands;
| | - Kenneth Meijer
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229ER Maastricht, The Netherlands;
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8
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Gandolla M, Antonietti A, Longatelli V, Pedrocchi A. The Effectiveness of Wearable Upper Limb Assistive Devices in Degenerative Neuromuscular Diseases: A Systematic Review and Meta-Analysis. Front Bioeng Biotechnol 2020; 7:450. [PMID: 32039171 PMCID: PMC6992540 DOI: 10.3389/fbioe.2019.00450] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 12/18/2019] [Indexed: 12/18/2022] Open
Abstract
Background: This systematic review summarizes the current evidence about the effectiveness of wearable assistive technologies for upper limbs support during activities of daily living for individuals with neuromuscular diseases. Methods: Fourteen studies have been included in the meta-analysis, involving 184 participants. All included studies compared patients ability to perform functional tasks with and without assistive devices. Results: An overall effect size of 1.06 (95% CI = 0.76-1.36, p < 0.00001) was obtained, demonstrating that upper limbs assistive devices significantly improve the performance in activities of daily living in people with neuromuscular diseases. A significant interaction between studies evaluating functional improvement with externally-assessed outcome measures or self-perceived outcome measures has been detected. In particular, the effect size of the sub-group considering self-perceived scales was 1.38 (95% CI = 1.08-1.68), while the effect size of the other group was 0.77 (95% CI = 0.41-1.11), meaning that patients' perceived functional gain is often higher than the functional gain detectable through clinical scales. Conclusion: Overall, the quality of the evidence ranged from low to moderate, due to low number of studies and participants, limitations in the selection of participants and in the blindness of outcome assessors, and risk of publication bias. Significance: A large magnitude effect and a clear dose-response gradient were found, therefore, a strong recommendation, in favor of the use of assistive devices could be suggested.
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Affiliation(s)
- Marta Gandolla
- Nearlab@Lecco, Polo Territoriale di Lecco, Politecnico di Milano, Lecco, Italy
| | - Alberto Antonietti
- Nearlab, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Valeria Longatelli
- Nearlab, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Alessandra Pedrocchi
- Nearlab, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
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